Pediatric Readiness at Scale: A System-Wide Pediatric Readiness Story from Geisinger Health System
Geisinger Health System is a large, integrated health system serving primarily rural and semi-rural communities across Pennsylvania. Its emergency departments (EDs) range from small rural hospitals to larger regional centers, many separated by long distances and serving populations that may travel hours for emergency care. Within this complex system, ensuring consistent, high-quality pediatric emergency care requires coordination, trust, and sustained effort.
Three clinicians—Megan Zelonis, RN, pediatric emergency care coordinator (PECC) and program manager, Sarah Alander MD, former director of Pediatric Emergency Medicine, and Steven Jason Crellin DO, current director of Pediatric Emergency Medicine—have helped lead that effort across the system. For them, Pediatric Readiness is deeply personal.
“I have kids,” Crellin shared. “I want every ED to be ready to take care of children, including my own, if and when they need it.”
In communities where families may have limited access to pediatric specialty care and long transport times, readiness can be the difference between confidence and crisis.
Zelonis echoed that perspective. “Many of the communities we serve are small and close-knit. These aren’t anonymous patients—they’re neighbors, friends, and family. Pediatric Readiness means making sure children receive the best possible care, no matter which Geisinger ED they walk into.”
Building a System-Wide Foundation
Their work gained structure and momentum through participation in the National Pediatric Readiness Project (NPRP) Assessment, which provided a clear baseline across hospitals and a shared framework for improvement.
“That assessment gave us a starting point,” Zelonis explained. “It showed us where we were doing well and where we needed to focus our energy.”
From there, Geisinger expanded its efforts by participating in regional and national readiness efforts, partnering with the federal Emergency Medical Services for Children (EMSC) Program to join quality improvement collaboratives and participating in EMSC Scholars and Fellows initiatives. Over time, these activities coalesced into a fully functional EMSC Council that meets monthly to coordinate Pediatric Readiness initiatives across the entire Geisinger system.
Success Through Collaboration
The results have been tangible: Pediatric Readiness scores in the top quartile nationally, standardized pediatric resuscitation equipment across hospitals, and regular simulation-based training that builds confidence and relationships among staff. But when asked what matters most, both leaders point to people—not metrics.
“The biggest heroes are our nurses,” Crellin said. “They’re the ones who advocate for better care and push improvements forward every single day.”
Zelonis added, “Real change happens when you meet people where they are. When you understand the realities of their ED and their barriers, you can build solutions that actually work.”
Geisinger's approach has also resonated beyond the health system. Working alongside the Pennsylvania EMSC State Partnership program, their hub-and-spoke model — a children's hospital supporting system-wide EDs — has been adopted as a framework for Pennsylvania's Prepared for Pediatrics and Partners in Pediatrics Pediatric Readiness Recognition Programs, offering a replicable blueprint for all health systems, whether a system like Geisinger's, regional referral centers working with neighboring EDs, or local hospitals supporting EMS partners.
The Reality of Rural Emergency Care
Across Geisinger’s footprint, many ED clinicians may see critically ill children only a few times a year. Resources and staffing vary by site, but expectations remain the same.
“Pediatric patients aren’t the majority in many of these EDs,” Crellin explained. “So when a very sick infant arrives, it can be intimidating. Our role is to support teams, build skills, and make sure they’re never facing that situation alone.”
Advice for Other Systems
For large systems—or any ED—hesitant to begin their Pediatric Readiness journey, their advice is practical and reassuring.
“Start small,” Crellin said. “People picture a massive overhaul, but meaningful progress comes from addressing the low-hanging fruit and building from there.”
Zelonis agreed. “Build trust, meet people where they are, and grow together. That’s how you create sustainable, system-wide change.”